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Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

HCPCS code

Name of the Procedure:

Elbow Wrist Hand Orthosis (EWHO)

Summary

An Elbow Wrist Hand Orthosis (EWHO) is a customized brace designed to support and immobilize the elbow, wrist, and hand. The orthosis typically includes nontorsion joints, elastic bands, or turnbuckles and may feature soft interfaces and straps. It is custom-fabricated to fit the patient's unique anatomy and includes fitting and adjustment.

Purpose

The EWHO is used to treat and manage various conditions affecting the elbow, wrist, and hand, such as injuries, post-surgical recovery, and chronic conditions. The goal is to provide support and stabilize the affected areas, reduce pain, and enhance functional use of the arm and hand.

Indications

  • Fractures and injuries to the elbow, wrist, and hand
  • Post-operative support following surgery on the elbow, wrist, or hand
  • Chronic conditions such as arthritis or carpal tunnel syndrome
  • Neuromuscular disorders that impair arm and hand function
  • Conditions requiring joint immobilization or stabilization

Preparation

  • Pre-procedure evaluation by a healthcare provider to determine the suitability of the orthosis
  • Measurement and assessment of the arm to fabricate a custom-fit orthosis
  • No specific fasting or medication adjustments usually required

Procedure Description

  1. The healthcare provider assesses the patient's arm, focusing on the elbow, wrist, and hand.
  2. Precise measurements and molds of the arm are taken to create the custom orthosis.
  3. The orthosis is fabricated using durable materials and configured with nontorsion joints, elastic bands, and possibly turnbuckles.
  4. Soft interfaces and straps are added to ensure comfort and secure fit.
  5. During the fitting appointment, the orthosis is adjusted to fit the patient's arm properly.
  6. Instructions for wearing and adjusting the orthosis are provided.

Duration

The initial fitting and adjustment appointment typically takes 1 to 2 hours. Fabrication of the orthosis may take several days to a few weeks.

Setting

The procedure is usually performed in an orthopedic clinic, rehabilitation center, or prosthetics and orthotics facility.

Personnel

  • Orthopedic specialist or physical therapist
  • Registered nurse or medical assistant
  • Orthotic technician

Risks and Complications

  • Skin irritation or pressure sores
  • Misalignment or improper fit
  • Limited range of motion leading to stiffness
  • Discomfort or pain

Benefits

  • Provides stabilization and support to the elbow, wrist, and hand
  • Reduces pain and discomfort
  • Aids in the healing process post-injury or post-surgery
  • Enhances functional use of the arm and hand

Recovery

  • Patients should wear the orthosis as directed by their healthcare provider.
  • Skin care instructions will be provided to avoid irritation.
  • Regular follow-up appointments may be needed to adjust the orthosis.
  • Typical recovery time varies based on the underlying condition and its severity.

Alternatives

  • Standard wrist, elbow, or hand braces available off-the-shelf
  • Physical therapy and rehabilitation exercises
  • Pain management medication or injections
  • Surgical intervention for severe cases
Patient Experience
  • Patients may experience initial discomfort or stiffness as they adapt to the orthosis.
  • Pain management strategies include over-the-counter pain relievers and following prescribed wearing schedules.
  • Periodic adjustments may be required to ensure comfort and effectiveness.

Medical Policies and Guidelines for Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment

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